In October 2014, the Water andSanitation Program (WSP) initiated a study to document itsengagement in the rural sanitation sector in India between2002 and 2013. The intent was to learn from achievements,challenges, and lessons from the past as the Water GlobalPractice of the World Bank and other stakeholders intensifyefforts to address the huge challenge of realizing theGovernment of India’s goal of universal rural sanitation inIndia by 2019. The study covered a cross-section of eightstates in which WSP has worked as well as an examination ofactivities at the national level. The primary source ofinformation was 138 structured interviews with keyinformants including Indian Government officials at alllevels: (a) representatives of development agencies andcivil society organisations; and (b) current and former WSPstaff. The key findings were as follows: (i) Creatingchampions is a key determinant of success, and new, morecost-effective, and scalable approaches must be developed;(ii) Effective ways must be found to increase awareness andwillingness to act among senior decision makers at statelevel; (iii) New implementation models must be developedthat support the work of state governments to roll outsanitation at scale, and state governments must be supportedto institutionalize them; and (iv) Mechanisms must be foundto support decentralized, large-scale sector capacitybuilding. These insights will be used to develop futureinterventions that will further accelerate change and helpachieve the goal of universal rural sanitation in India